Abstract 16474: BP Reduction With the Sodium Glucose Co-Transporter 2 Inhibitor Empagliflozin in Type 2 Diabetes is Similar in Treatment Naïve as in Those on One or ≥ 2 Antihypertensive Agents - Further Insights From a Dedicated 24h ABPM Study
In patients with type 2 diabetes (T2D) hypertension is accompanied by an increase in CV risk which can be substantially attenuated if BP is lowered by drug treatment. Empagliflozin (EMPA) is a new glucose-lowering agent of the sodium glucose co-transporter 2 inhibitor (SGLT2i) class, which has been shown to reduce body weight and also lower BP. It is not known, however, whether the EMPA-related BP lowering effect is preserved in patients under background antihypertensive treatment. We investigated the effect of 12 weeks with EMPA on 24 hour (h) mean BP in 823 T2D patients (age 60.2 ± 9.0 years, HbA1c 7.9 ± 0.7%, office systolic (S)/diastolic (D) BP 142.1 ± 12.3/83.9 ± 7.0 mmHg, mean ± SD) in a study with a randomized design. EMPA was given at 10mg (n=276) or 25mg (n=276) daily; 271 patients were randomized to placebo. Patients were under no, 1 or ≥ 2 antihypertensive drugs (n= 62, 353 and 408, respectively) such as an ACE inhibitor (ACEI), an angiotensin receptor antagonist (ARB) or a diuretic (D). HbA1c and weight were significantly reduced with EMPA 10 mg (mean [SE] -0.62% [0.05], -1.5 kg [0.2]) and EMPA 25 mg (-0.65 [0.05], -2.0 [0.2]) relative to placebo (all p < 0.001). As shown in the Table, compared to placebo, EMPA at the lower or higher dose reduced 24h mean SBP and DBP in all groups. With the lower dose the BP reduction was somewhat less pronounced in patients with ≥ 2 antihypertensive drugs whereas with the higher dose the BP effect was similar irrespective of the presence and intensity of background antihypertensive treatment. The antihypertensive effect of EMPA was preserved also irrespective of the type of treatment (D and ACEIs or ARBs), especially at the higher dose. Thus, EMPA reduces BP in patients with T2D regardless of whether they are untreated or more or less intensively treated for hypertension.
Author Disclosures: G. Mancia: Consultant/Advisory Board; Modest; Boehringer-Ingelheim. C.P. Cannon: Consultant/Advisory Board; Modest; Boehringer-Ingelheim. I. Tikkanen: Consultant/Advisory Board; Modest; Boehringer-Ingelheim. C. Zeller: Employment; Significant; Boehringer-Ingelheim. L. Ley: Employment; Significant; Boehringer-Ingelheim. T. Hach: Employment; Significant; Boehringer-Ingelheim. H. Woerle: Employment; Significant; Boehringer-Ingelheim. U.C. Broedl: Employment; Significant; Boehringer-Ingelheim. O. Johansen: Employment; Significant; Boehringer-Ingelheim.
- © 2014 by American Heart Association, Inc.